Association between arterial oxygen and mortality across critically ill patients with hematologic malignancies: results from an international collaborative network
Authors' conclusion
In critically-ill patients with hematological malignancies, exposure to hyperoxemia and excess oxygen use were associated with increased mortality, with variable magnitude across subgroups.
Study context
- Population
- Critically ill patients with hematologic malignancies receiving respiratory support (NIV, HFNC, invasive mechanical ventilation), cohorts from Europe, Canada, Oceania
- Participants
- 11,249 patients · 3 international cohorts
- Exposure
- Day-one pressure of arterial oxygen (PaO2) categories and excess oxygen use
- Normoxemian = 5,716reference
- Hypoxemian = 1,454
- Hyperoxemian = 4,079
- Outcome
- Mortality (association with day-one PaO2)
- Follow-up
- 28 days
Methodological detailsinternational multicohort, mixed-effect Cox models, propensity score analysis
- International multicohort
- Mixed-effect Cox models
- Propensity score analysis
Main finding
As reported in the abstract
Day-28 mortality by day-one PaO2 · day 28
- Significant U-shaped association between PaO2 and day-28 mortality
- P < 0.001
- Crude day-28 mortality rate
- 40.6%
Observational data: associations, not effects.
Further findings
Day-28 mortality with excess oxygen use (FiO2 ≥ 0.6 with PaO2 > 100 mmHg)
| aHR (95% CI) | ||
|---|---|---|
| Excess oxygen | 1.11 (1.04–1.19) | |
| 0.512Adjusted hazard ratio (log scale) |
| Outcome | Matched HR |
|---|---|
| Day-28 mortality with excess oxygen use (FiO2 ≥ 0.6 with PaO2 > 100 mmHg)Excess oxygen · propensity score analysis; CI misprinted in abstract | 1.31 |
- Day-28 mortality with excess oxygen use (FiO2 ≥ 0.6 with PaO2 > 100 mmHg): Excess oxygen used in 2201 patients (20%)
Hyperoxemia and mortality by admission reason (subgroup)
- Association between hyperoxemia and mortality in patients admitted with neurological disorders; opposite relationship in those admitted with sepsis and neutropenia
Original publication
Association between arterial oxygen and mortality across critically ill patients with hematologic malignancies: results from an international collaborative network. Intensive Care Med. Published 10 April 2024. doi:10.
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